There is a branch of Mindfulness called ‘Acceptance and Commitment Therapy’ (ACT) and twice recently I’ve been asked if I’ve heard of ACT for chronic pain; which I have thanks to Libby.
ACT, which was developed in the late 1990s, is an acceptance and mindfulness-based approach to therapy that can be applied to many problems and disorders, not just to chronic pain. It differs from Cognitive Behavioural Therapy (CBT) in that instead of challenging distressing thoughts by looking for evidence and coming up with something more rational, in ACT the thought is simply accepted as just that – a thought, and then defused using a variety of different techniques, which broadly fall into 3 categories – mindfulness, acceptance and value-based living.
In so doing, a person is able to break out of self-defeating patterns of behaviour which can leave them feeling drained and feeling as though they are just existing, not living.
ACT for chronic pain
As Libby so neatly explains in her article: “Mindfulness, particularly a branch of it called acceptance and commitment therapy, encourages sufferers of chronic pain to stop battling their pain and accept that it’s part of them. Taking your body out of its state of constant heightened alert and accepting that the pain won’t actually damage you is not an easy thing to do, but it can reap huge benefits.”
Put another way, while pain hurts, it’s the mind’s struggle with the pain that causes suffering.
ACT is recognised by the National Institute for Health and Care Excellence (NICE) and is increasingly available on the NHS. However, the NHS are keen to highlight that ACT, or their particular approach to it, may not be for everyone:
“We consider ACT to sit somewhere between a therapy and a learning group. Part of attending involves a commitment to engage in mindfulness-based exercises, which might involve you experiencing difficult thoughts, feelings and sensations, that you have tried to control or push down in the past. This requires an open and willing attitude of mind. This is something we will discuss at your triage appointment; having and handling feelings in a group may not be suitable for everyone.
“ACT is all about having and handling feelings, making a commitment to attend weekly sessions, and devoting time outside the session to reading and practising skills, it may not be the group for everyone.”
Does it work?
Much of the published research seems to conclude either that ACT is effective (to a greater or lesser extent) for people suffering chronic pain or that the results are simply inconclusive. Either way, it is unlikely that participating in ACT is going to make you feel worse in the long term. To that extent, if it’s available to you, there seems little to lose in giving it a go.
The NHS are of course quite right to highlight that group therapy is not for everyone. In my experience, many people struggle in that scenario, particularly men, and private individual therapy is financially out of reach for many people suffering chronic pain.
However, if you suffer chronic pain and are going through a claims process, if your legal representative is experienced they will be able to advise you on treatment options and obtaining funding for treatment.